Enhancing Livelihoods

Health & hygiene

Lack of safe drinking water, and poor sanitation and hygiene, cause millions of preventable deaths each year - particularly among children.

The World Health Organization estimates that tackling these interconnected issues has the potential to prevent at least 9% of global disease, and 6% of all deaths.1 Evidence shows that people will be healthier and happier, and communities more productive, if they have improved access to better sanitation, safe drinking water, and basic levels of hygiene. This is essential to lifting people out of poverty.

But health is not just about hygiene. Many people worldwide suffer from low self-esteem and feel anxious about their bodies. And this can have a knock-on effect on their personal lives and careers. Through Dove, our leading personal care brand, we’re helping women and girls to be confident in their own bodies and build their self-esteem.

The Health & Hygiene pillar of our Unilever Sustainable Living Plan (USLP) primarily contributes to two of the UN Sustainable Development Goals (SDGs): Good Health and Well-being (SDG3); and Clean Water and Sanitation (SDG 6).

Our strategy

Our aim is to help more than a billion people to improve their health and hygiene by 2020.

Addressing health & hygiene makes business sense

Addressing social challenges is good for society and good for business. Many of our programmes drive growth directly - our oral care, handwashing and sanitation programmes are strong examples. When more people brush their teeth, use soap regularly, and have access to sanitation, their use of toothpaste, soap and toilet cleaner increases. Domestos is helping to give people access to improved sanitation which drives market development for our business.

We run many of our health and hygiene initiatives through brands in our Personal Care category. This is the largest product category in our business with €20.7 billion turnover in 2017 and accounts for 39% of our turnover and 46% of our operating profit. It is home to brands such as Dove, Signal and Lifebuoy. Lifebuoy is the world’s number one antibacterial soap brand. Sold in nearly 60 countries, it grew 6% in 2017.

Our Home Care category generated turnover of €10.6 billion in 2017, accounting for 20% of our turnover. It includes our water purifiers Pureit and Qinyuan as well as Domestos, our market-leading toilet cleaning brand, which has a strong presence in emerging markets. Domestos is helping to give people access to improved sanitation and driving market development for our business. Domestos grew by 10% in 2017.

Our approach

Providing quality, affordable products is only part of the solution to improve health through hygiene. Products alone are not enough. A big part of our work is encouraging people to adopt healthy habits. Studies show that most people know they should brush their teeth twice a day, and wash their hands with soap after going to the toilet and before eating, but often they don't.

As one of the world's leading consumer goods companies, making products that people use every day, we understand the triggers, barriers and motivators that generate sustained behaviour shifts. Underpinning our approach is our behaviour change model, the Five Levers for Change (EN) (PDF | 4MB). This is a set of principles that when applied consistently, increases the likelihood of creating a lasting impact. We use this knowledge, coupled with our expertise in marketing and in delivering campaigns at mass scale, to catalyse enduring change in everyday behaviours.

Innovation

We’re using our expertise to come up with innovative products that can help more people live healthier lives. For example, Lifebuoy’s new Mickey Mouse No-Touch Foaming Hand Wash, launched in China in 2017, makes it fun for children to wash their hands properly.

Our water purifiers offer water that is not only safe and convenient to use, but that tastes good too. We have extended their appeal by communicating superior safety and have introduced models that tackle increasing problems such as removing total dissolved salts (TDS) from drinking water, and models that dramatically improves the removal of the pesticide residues that are frequently found when washing leafy vegetables.

Advocacy & partnerships

In July 2010, through Resolution 64/292, the UN General Assembly explicitly recognised the human right to water and sanitation. It acknowledged that safe and clean drinking water and sanitation are essential to full enjoyment of life and all human rights. Unilever respects these rights by ensuring that we operate our business in a way that fulfils the human right to water, as defined by the UN Human Right to Water Policy.

Heads of state from all around the world gathered in New York in September 2015 to adopt the 2030 Agenda for Sustainable Development, resulting in 17 Sustainable Development Goals (SDGs). SDG 6 focuses purely on water and sanitation, aiming to “ensure availability and sustainable management of water and sanitation for all.” We worked with others to call for hygiene to be included as a key component within this SDG and welcomed the inclusion of indicators measuring access to handwashing with soap facilities.

Through our brands, behaviour change programmes and by joining forces with others around events - such as the UN General Assembly, Regional Water, Sanitation and Hygiene summits, and World Toilet Day – with our partners, we’re contributing towards achieving SDG 6.

Partnering with organisations who share our ambition to improve health through better hygiene is critical to our programmes achieving a positive impact on a large scale. We work with partners in many ways, including: joint advocacy programmes to raise the profile of issues; scaling-up existing programmes; piloting initiatives; and securing additional funding to increase the impact of our joint investment.

Businesses are well-placed to work with governments, civil society and development agencies to drive transformational and sustainable change at scale. Whether it’s through our understanding of consumers, knowledge of behaviour change, the design of innovative products, our ability to deliver programs at mass scale or the provision of financing, we bring a host of resources and knowledge to the table that can strengthen our collaborations. And in turn, improve people’s health and well-being while simultaneously growing our business.

Catalysing interested groups to come together around a shared objective is something we have found particularly useful. The Toilet Board Coalition is one example which Unilever was a founding member of - a global, business-led alliance of companies, investors, sanitation experts and non-profit organisations, which aims to develop sustainable and scalable solutions to the sanitation crisis.

Our commitment

By 2020, we will help more than a billion people take action to improve their health and hygiene. This will help reduce the incidence of life-threatening diseases like diarrhoea - one of the biggest causes of deaths in children under five.

Progress to date

Seven years into our Unilever Sustainable Living Plan, we’ve learnt that it’s possible to reach people at scale. By the end of 2017 we had succeeded in reaching around 601 million people: over 426 million people with Lifebuoy; over 10 million with improved access to a toilet1; nearly 78 million with our toothpaste brands; 29 million through Dove self-esteem programmes; 2.6 million through Vaseline’s Healing Project and over 55 million with safe drinking water from Pureit. Pureit also provided 96 billion litres of safe drinking water.

We continued to help improve sanitation through our global partnership with UNICEF, began our Local Sanitation Support Programme in partnership with Population Services International (PSI), and rolled-out sanitation initiatives in schools.

Future challenges

Lifebuoy runs one of the world's largest handwashing programme. In order to reach our 1 billion target, we are finding ways to deliver effective handwashing behaviour change at an even lower cost. Currently, Lifebuoy only counts those people reached through on-ground programmes. However, we have long believed that the totality of our marketing efforts are contributing to changing handwashing behaviour, including mass scale TV advertising.

So, to test this, we ran a study in India - our biggest market - to assess the effectiveness of specific Lifebuoy TV adverts, using the same methodology that we use to evaluate our on-ground programmes. The study showed a significant increase in the frequency of handwashing with soap after people watched the adverts. This result demonstrates that mass media can promote and impact positive health behaviours at scale, giving us the opportunity to reach millions more people through our Lifebuoy brand - and potentially bringing us closer to our 2020 target of reaching 1 billion people.

As a next step, we are progressing peer review publication and aim to include TV reach in our Health & Well-being performance figures for 2018 alongside our on-ground programme reach.

For our range of water purifiers, our immediate priority is to strengthen and expand operations in existing markets. Acquiring the Qinyuan water purification business in China in 2014 added to our capabilities. However, to build scale, we need stronger distribution and after-sales service capabilities. We also need to build further partnerships with micro-finance institutions to make purifiers more affordable to low-income consumers.

Having clean, safe toilets in schools is important for pupil’s health and particularly for girls’ participation in school as poor toilet access is a key reason why girls skip or drop out of school when they start having their periods. But for toilets to be used continually over time, a fundamental shift in behaviour is needed.

So, we are supporting initiatives that drive behaviour change through a number of different routes, such as continuing our support of UNICEF’s sanitation programme. We are also supporting the operation and maintenance of toilets in schools through behaviour change interventions, to ensure that school toilets are kept in a clean and working condition, so they can be continually used over time.

1 Results are reported by UNICEF in accordance with its methodology and includes reach from direct and indirect initiatives over 2012-2016.

Targets & performance

We have set ambitious targets to meet people’s needs for good health and hygiene.

Health & hygiene

Our commitment

By 2020, we will help more than a billion people to improve their health and hygiene. This will help reduce the incidence of life-threatening diseases like diarrhoea.

Our performance

Around 601 million people reached by end 2017 through our programmes on handwashing, sanitation, oral health, self-esteem and safe drinking water: over 426 million people with Lifebuoy; over 10 million with improved access to a toilet*; nearly 78 million with our toothpaste brands; 29 million through Dove self-esteem programmes; 2.6 million through Vaseline’s Healing Project and over 55 million with safe drinking water from Pureit. Pureit also provided 96 billion litres of safe drinking water by the end of 2017.

Our perspective

We are on track to meet our 2020 commitment. By the end of 2017, we had reached around 601 million people, up from 538 million in 2016.

Our Signal and Pepsodent toothpaste brands reached their 2020 target of reaching 50 million people early, and by 2017 had reached nearly 78 million people through our Brush Day & Night campaigns.**

Dove achieved its 2015 target a year early, and reached nearly 20 million by 2015. In 2016 we extended our target to reach a further 20 million young people – our ambition now is to help a total of 40 million young people improve their body confidence and self-esteem by 2020.

In 2014, we introduced a new target for sanitation, with Domestos working with UNICEF to scale up sanitation improvement initiatives. Over 2012-2016, we enabled over 10 million people to gain improved access to a toilet.*

And in 2017, we introduced a further target: though our Vaseline Healing Project, we aim to help heal the skin of 5 million people by 2020. By 2017, we reached 2.6 million people through our Vaseline Healing Project, setting us on our way to help heal the skin of 5 million people by 2020.

* Results are reported by UNICEF in accordance with its methodology and includes reach from direct and indirect initiatives over 2012-2016.

Our targets

Please see Independent Assurance for more details of our assurance programme across the Unilever Sustainable Living Plan.

Reduce diarrhoeal and respiratory disease through handwashing

By 2020 our Lifebuoy brand aims to change the hygiene behaviour of 1 billion consumers across Asia, Africa and Latin America by promoting the benefits of handwashing with soap at key times.

In 2015, we extended our target from 2015 to 2020.

Over 426 million people reached since 2010.

Our Perspective

Our major challenge is scaling up programmes cost-effectively. Since 2010, we have made strong progress, reaching over 426 million people and developing models which more than halve the cost per contact.

However, our current programmes rely on direct contact interventions. Although we have reduced the cost per contact while maintaining effectiveness, we are constantly identifying new channels to optimise costs further and enabling us to reach greater scale each year. We are continuing to evaluate how partners and the use of new technology can help to deliver behaviour change more efficiently and effectively, for instance by using new channels and targeting key moments.

While our programmes have focused on reaching children and mothers on-ground, we have long believed that the totality of our marketing efforts are contributing to changing handwashing behaviour, including mass scale TV advertising. So, to test this, we ran a study in India - our biggest market - to assess the effectiveness of specific Lifebuoy TV adverts. We used the same methodology that we use to evaluate our on-ground programmes.

The study showed a significant increase in the frequency of handwashing with soap after people watched the adverts. This result demonstrates that mass media can promote and impact positive health behaviours at scale, giving us the opportunity to reach millions more people through our Lifebuoy brand - and potentially bringing us closer to our 2020 target of reaching 1 billion people. As a next step, we are progressing peer review publication and aim to include TV reach in our Health & Well-being performance figures for 2018 alongside our on-ground programme reach.

Our range of water purifiers is available in 12 countries: Bangladesh, Brazil, China, Ghana, India, Indonesia, Kenya, Mexico, Nigeria, Pakistan, the Philippines and Sri Lanka. The combined populations in these markets represent half the population of the world. Over 2005-2017, we provided 96 billion litres of safe drinking water, with over 11 billion litres in 2017.

We expanded our business in China with the acquisition in 2014 of the Qinyuan Group, China’s largest water purifying company.2 Water purification is a growing global category for our business, with underlying sales growing by 7.7% in 2017.

We continue to enhance our product offerings to appeal to consumers across different income levels and markets. Our most affordable model costs around €20 in India (INR 1,500), with an ongoing running cost of just over one euro cent for just over three litres of safe drinking water. This is lower than the cost of boiling water and significantly less than buying bottled water.

1
We revised our target in 2014 to reflect what matters most for health – the ongoing consumption of safe drinking water. The new metric also allows us to capture the ongoing consumption of safe water (litres) that is a stronger surrogate measure of the ongoing health impact, versus just providing one-off devices. It improves on our previous metric of people reached, which measured sales of our purifiers multiplied by the average household size to give a number of people reached on average by each device. Over 2005-2013, 55 million people used Pureit.

2
Qinyuan is not yet included in our calculation of litres of safe drinking water provided.

By 2020 we will help 25 million people gain improved access to a toilet by promoting the benefits of using clean toilets and by making toilets accessible.

Over 2012-2016, we helped over 10 million people gain improved access to a toilet.*

Our Perspective

When we added this target to the Unilever Sustainable Living Plan in 2014, we became the first company to make a commitment to improving sanitation on this scale. Over 2012-2016, Domestos’s partnership with UNICEF has helped over 10 million people gain improved access to a toilet.*

Sanitation is one of the most complex areas of development. We are working with partners to roll out quality sanitation programmes with increasing speed and scale. In 2017, we continued our global partnership with UNICEF and rolled-out sanitation initiatives in schools. In 2016 we opened our pioneering Suvidha Centre in India, a sustainable community centre for over 1,500 people in low income households, offering toilets, handwashing, showers, washing machines and safe drinking water at below market prices.

* Results are reported by UNICEF in accordance with its methodology and includes reach from direct and indirect initiatives over 2012-2016.

We will use our toothpaste and toothbrush brands and oral health improvement programmes to encourage children and their parents to brush day and night. We aim to reach 50 million people by 2020.

We achieved our target early, reaching over 50 million people. By 2017, our total increased to nearly 78 million. We reached just under 3 million people in 2017.

Our Perspective

Signal/Pepsodent’s mission is to improve oral health by encouraging families to brush morning and night using fluoride toothpaste.

Research shows that long-term brushing habits are best forged during childhood, so we focus on instilling good habits from an early age, and encourage positive parental role modelling. Our Brush Day and Night campaign, a fun and engaging school programme, has been proven to increase brushing frequency by 25%. These Brush Day and Night materials are available on the brand website, so anyone can get involved in teaching good brushing habits for life!

Our approach has also been good for business. In 2017, this Sustainable Living brand grew by 4% globally.

With our Dove brand we are helping millions of young people to build up positive body confidence and self-esteem through educational programmes.

By 2015 we aimed to help 15 million young people. In fact, we reached nearly 20 million by 2015, and in 2016 we extended our target to help another 20 million young people by 2020.

19.5 million young people received our help over 2004-2015. By 2016, we reached 23 million. This figure grew to 29 million in 2017, setting us on our way to our ambition to help 40 million young people.

Our Perspective

We achieved our 2015 target a year early, and reached nearly 20 million by 2015. To keep up our ambition, in 2016 we extended our target to reach another 20 million young people – our aim now is to help a total of 40 million by 2020.

In 2017, we continued to accelerate the reach and quality of the Dove Self-Esteem Project, developing cost effective impactful implementation strategies. Dove celebrated its 60th anniversary by renewing its vows to women everywhere through the Dove Real Beauty Pledge.

On top of our school curriculum, we’re working with the World Association of Girl Guides and Girl Scouts to get the message across to more young women. Our Free Being Me programme has reached 4 million girls in over 125 countries since 2013 and we’re aiming to reach 6.5 million by 2020. In 2017 we developed a new badge programme, called Action on Body Confidence, to build up girls’ advocacy skills, allowing them to act as a life changer in smaller communities and reach even more girls.

Dove is one of our fastest growing Beauty and Personal Care brands, and grew by 6% in 2017.

Though our Vaseline Healing Project, we aim to help heal the skin of 5 million people by 2020.

By 2017, we reached 2.6 million people through our Vaseline Healing Project, setting us on our way to help heal the skin of 5 million people by 2020.

New target 2017

Our Perspective

By the end of 2017, we reached 2.6 million people through our Vaseline® Healing Project, which has helped heal the skin of people living at the frontline of disasters and emergencies since 2015.

The Vaseline® Healing Project is run in partnership with the international relief organisation, Direct Relief. Since 2015, we’ve donated 3.3 million jars and bottles of Vaseline® Jelly, as well as providing expert skin care and training for local health workers. The Vaseline Healing Project is committed to training local healthcare workers. In 2017, we trained 563 primary healthcare workers in dermatology to help diagnose and treat skin conditions across India, South Africa and Mexico.

In areas of prolonged need, such as Jordan, we provide support through skin care missions and product donations. In 2017, we established a full-time dermatological team, enabling year-round treatment across three refugee camps.

We are well on our way to achieving our 2020 target to heal the skin of 5 million people.